Surgical appliance



Oct. 16 1923.

s. A. BATES SURGICAL APPLIANCE Filed 00;. \12.

? Gunman,

INVENTOR WIT NESSES $.A. Bates,

A TTORNEYS amt Patented Get. 16, 1923. v

UNITED STATE PATENT ewes-.1

SAMUELALLEN BATES, OF ST. LOUIS,V1\ IISSOURI.

SURGICALAPPLIANGE. j l i 7 Application filed October 12, 1922. Serial No. 594,128. a a

To all whom it my concern:

Beitkn own that I, SAMUELA. BATES, a

citizen of theiUnited Statesand a resident of St. Louis in the State otMissouri, have invented certain new and useful Improvements in Surgical Appliances, of which the following s a specification. a

This invention relates to surgical appli-' ances and more particularly to a device for use in connection with surgicaloperations on the intestines and where such operations necessitate the severing of the lntestine.

An object of the invention is the provision of a thimble for maintaining the severed ends of anintestine, especially the ileum, distended after a surgical operation has been performed for the reliefof intussusception and after the ends of the intestines have been connected by a cat gut suture;

A furthen'object of the invention is the provision of a thiinble for the purpose, whichsis adjustablein line with the longitudinal axis ofthe thimble in order that said j thimble may be accommodated to intestines ofvarioussiZesL v A further objectof the invention is the provision of a thimble formed of asubstance which will melt at the proper time due "to'the heat of the body and be passed from the intestines, or which is capable of removal from the intestines in theintestine which has been severed and suture showing my in-v connected by cat gut vention in position. I v t Figure 2 is longitudinal sectionof the same showing my invention as applied to a severe'dportion of the intestine.

Figure 3: is aview in perspective of the 'thimble.

Figure 43 is alongitudinal section of the same.

Referring to the drawings; 1 indicates a thimble which is cylindrical in shape,vmade of some flexible. material which is capable of being melted by the heat of the human body or which may be removed from its position in the intestines in a normal ma nner by the use of a medicinal preparation, The material of which the thimble is composed may be wax, parafli'n orsoft rubber.

The wall of the cy inder is split along its longitudinal axis with the end 2 of the split portion overlapping the other end 3 of the split portion; The end 2 or" the split po-rtion is gradually reduced in thickness toward its outer edge 1 whereby the split 'cylinder with the overlapping ends 2 and 3 form substantially a cylindrical thimble which is adapted to be inserted between the severed ends of anintestine. v

Midway of the open ends of the thimble 1 and upon the outer wall of the same is formed an annular rib 5 with the innerwall V of said rib provided with an annular groove 6. The portions of the wall of thethimble on opposite sides of the rib 5' are depressed as shown at 7 and 8 forming annular grooves upon theouter wall of thethirnblei "The continuation of the rib 5 on the end 3 of the splitportion of the cylinder is adapted to be receivedwithin the groove 6 of the rib, which is continued on the other end 2 gt the split portion of the cylindrical memi i The opposite peripheral edges of the thimble are beveled as shown at 9 whereby the ends 10 and 11 of the intestine may be readily slippedover the opposite ends of the thimbleh 1 On opposite sides of the rib 5 are formed a pairof openings 12 which are adapted toreceive athread of cat gut 13 forming the suturewhereby the'ends of the intestine are connected together 'andby which the thimble 1 is anchored in position at the rupture of the intestine. While I have shown a pair of perforations only, I wish it to be understood that any number of perf0- rations may be used which maybe necessary to' properly anchor the thimble in proper relation with the rupture of the in testines whichhave been connected together by the suture. p

The overlapping ends 2 and 3 of the thimble permits a" decreasing of the cylindrical circumference where the thimble is employed with intestines of'smaller sizes, with said ends sliding over each other after such reduction. The thimble may be made of soft rubber, paraflin or wax and is adapted to be em is removed.

ployed for distending the severed portions of the intestines which have been secured tpgether by a cat gut suture after an operatlon for intussusception of the bowels which frequently occurs near the ileocteca-l valve.

Where intussusception of the ileum occurs due to various causes adhesion of the ileum frequently takes place and the adhesions are broken up by a dull instrument and'the invaginated ileum is drawn back in place. If it be found that the ileum is of too great a length, such unnecessary length of the ileum The thimble is slipped into place as shown in Figure 2 with the severed ends of the intestine forced over the beveledends 9 of the thimble until the severed ends of the intestine are located in end to end engagement with each other at the rib 5 of the thimble. The engaged ends of the intestine are sewed together by means of cat gut with a thread passing through the perforations 12 whereby the thimble is anchored in position within the intestine.

ten,

.of the intestines with ease.

By pressing upon opposite Walls of the thimble 1 the diameter of the thimble may be sufiiciently reduced that the thimble may be readily inserted Within the severed ends By relieving pressure on opposite points of the wall of the thimble the resilience of the thimble will cause the same to expand and neatly lit. the inner Wall of the intestine and thereby prevent leakage through the intestine at the severed portions The cat gut suture will hold the ends of the intestine together while the intestine is healing, but the thimble, When made of paraffin or war will eventually melt or become sufliciently soft whereupon it will be normally removed from the ileum. WVhere a rubber thimble is employed the same may be removed by treating the patient with olive oil until the thimble has passed from the ileum.

The thimble just described is not only adapted for use in operations for intussusception of the intestines but may be also employed in connection with any other operation where portions of the intestines are removed or severed. The thimbl e may be employed in operations for the relief of persons suflering from gun shot wounds of the intestines. The annular grooves 7 and 8 are depressed sufficiently in the wall of the thim ble to form a pair of parallel ribs on the innerfwall of the thimble. These ribs on one overlapping portion of the thimble. are

i adapted to seat in the, grooves 7 and 8 of the ether split portion and are slidable in said grooves when the thimble is formed to accommodate a cylinder of smaller diamet- The operation for intussusception of the bowels is performed on the small intestine at the ileocaeca-l valve and a blunt instrument is employed t break up the adhesion ofthe invaginated intestine. This portion of the bowel is then Withdrawn from its telescoping position and as much of the elongated intestineis removed as is sufiicient to prevent a recurrence of intussusception.

What I claim is:

1. A surgical appliance for use in connection with surgical operations on the intestines, comprising a cylindrical member made of flexible material having its walls split along the longitudinal axis of the cylinder, with the split ends located in overlapping relation and slidable on each other whereby the circumference of the cylinder may be varied to fit intestines of different sizes, an annular rib formed on the outer wallof the cylinder midway of its ends, the opposite ends of the cylindrical member bcingbeveled, the rib being provided with a groove on its inner wall with an end of the groove on one split portion of the cylinder adapted to receive theoppos'ite end of the rib on the other split portion of the cylindrical member, the end of the outer overlapping split portion of the cylinder being gradually reduced in thickness; toward its edge, said rib being provided with perforations for receiving the cat gut suture employed for connecting the severed ends of an intestine for anchoring the cylinder in place in an intestine.

2. A surgical appliance for use in connection With surgical operations. on the intestines, comprising a cylindrical member made of flexible material having its walls split along the longitudinal axis of the eyiinder, with the split ends located in overlapping relation and slidable on each other whereby the circumference of the cylinder may be varied to fit intestines of different sizes, an annular rib formed on the outer wall of the cylinder midway of its ends, the, opposite ends of the cylindrical, member being beveled, the rib being provided with a groove on its innerv wall with an end of the groove on one split portion of the cylinder adapted to receive the opposite end of the rib on the other split portion of the cylindrical member, the end of the outer overlapping split portion of the cylinder being gradually reduced in thickness toward its edge, said rib being provided, with, perforations for receiving the cat gut suture employed for connecting" the severed ends of an intestine for anchoring the cylinder in place in an intestine, the wall of the cylindrical member being provided with lindrical member and seated within the grooves of the first mentioned overlap-ping portion.

3. A surgical appliance for use in connection with surgical operations on the intestines comprising a cylindrical member made of flexible material having its walls split along the longitudinal axis of the cylinder with the split ends located in overlapping relation and slidable on each other whereby the circumference of thecylinder may be varied to fit intestines of different sizes, said cylinder being'provided with perforations adapted to receive certain of the cat gut sutures employed in connecting the severed ends of an intestine for anchoring the cylinders in place in the intestine.

4. A surgical appliance for use in connection with surgical operations of the in testines comprising a cylindrical member,

made of flexible material, a rib formed on the outer wall of the cylindrical member and intermediate its ends, a plurality of perforations formed in the wall of the cylinder adjacent the rib for receiving a portion of the cat gut suture employed in connecting the severed ends of an'intestine.

5. A surgical appliance for use in conand intermediate its ends, a plurality nection with surgical operations of. the intestines comprising a cylindrical member made of flexible material, a rib formed on the outer wall of the cylindrical member perforations formed inthe wall of the cylinder adjacent the rib for receiving a portion of the cat gut suture employed in connecting the severed ends of an intestine, the opposite 'endsof the. cylinder being beveled.

6. A surgical appliance for use in connection with surgical operations on the intestines comprising, a cylindrical member made of flexible material having its walls split along the longitudinal axis of the cylinder with the split ends located in overlapping relation and slidable on each other whereby the circumference of the cylinder may be varied to fit intestines of different sizes, said cylinder being provided with perforationsadapted to receive certain of the cat gut sutures employed in connecting the severed ends of an intestine for anchoring the cylinders in place in the intestine, and a rib on the outer wall of the cylindrical member located intermediate the ends of said cylinder.

SAMUEL ALLEN BATES. 

